The comparison of the effectiveness of invasive and conservative treatments combined with external counterpulsation in myocardial infarction patients with recurrent myocardial ischemia

The aim of the research was to compare the effectiveness of invasive and conservative treatment of acute myocardial infarction, complicated by recurrent myocardial ischemia. Sixty-five patients with recurrent myocardial ischemia were included in the research. Some patients underwent percutaneous coronary intervention (PTCI) (1st group - n=21). Other patients were randomized into groups: of external counterpulsation (2nd group - n=18) and control group (3rd group 3 - n=26). Medical treatment was the same in the 2nd and 3d groups. There are significant differences in the lesion of coronary arteries between groups. The damage of the main left coronary artery had 1, 2, and 2 patients (1st; 2nd; and 3rd groups accordingly). The multivessel disease was detected in 9 (43%), 10 (77%), 14 (74%) patients (accordingly, р=0.06). And the single coronary artery disease was detected in 6 (29%), 1 (8%), 0 patients, (accordingly, р=0.02). Incidence of angina was the same in patients of 1st and 2nd groups by the discharge from hospital (4 and 2 patients accordingly), whereas more than half of patients of 3rd group had angina (15 patients out of 26, р=0.001). The recurrent myocardial infarctions, lethal outcomes during hospitalization were decreased in 2- and 4-fold in patients of counterpulsation group. External counterpulsation is safe for myocardial infarction patients with recurrent myocardial ischemia. External counterpulsation decrease incidence of angina, this effect is comparable with PTCI. External counterpulsation reduces adverse events in comparison with the group of medication treatment only.